Pharm

Droperidol

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Droperidol, Inapsine

  1. Antiemetic in refractory Vomiting
  2. Surgical or Diagnostic procedure
    1. Procedure related Nausea or Vomiting
    2. Conscious Sedation
  3. Migraine Headache
  4. Chemical Restraint (e.g. violent patient)
  • Contraindications
  1. Absolute contraindications
    1. QT Prolongation prior to use (>440 ms)
  2. Relative contraindications: Risk of QT Prolongation
    1. Congestive Heart Failure
    2. Bradycardia (Heart Rate <50 beats per minute)
    3. Concurrent Diuretic use
    4. Cardiac hypertrophy
    5. Hypokalemia
    6. Hypomagnesemia
    7. Other medication use associated with QT Prolongation
      1. Class I Antiarrhythmics
      2. Class III Antiarrhythmics
      3. Monoamine Oxidase Inhibitors
  • Mechanism
  1. Butyrophenone Neuroleptic similar to Haloperidol
  2. Antiemetic activity via Dopamine antagonist
  • Adverse effects
  1. QT Prolongation
    1. FDA Black box warning due to observed QT Prolongation at therepeutic doses
    2. Studies have since demonstrated its safety when used at moderate dose
      1. Calver (2015) Ann Emerg Med 66(3): 230-8 +PMID:25890395 [PubMed]
  2. Sedation
    1. Usually resolves within 4 hours of dose
    2. Alertness may be decreased for 12 hours after dose
  • Drug Interactions
  1. Other agents that prolong QT Interval (see above)
  • Dosing
  1. Adults: 2.5 mg IM or IV slowly
  2. Children: 0.1 mg/kg IM or IV slowly
  • Monitoring
  1. Baseline EKG
  2. Continuous cardiac monitoring for 3 hours after dose